The increasing complexity of healthcare needs driven by an ageing population places pressure on district nursing care. Many vulnerable older adults prefer to remain at home, requiring care coordinated with general practitioners and other professionals. This demand for integrated care is further challenged by a shortage of nursing professionals and the lack of standardised approaches to measure care quality. This article identifies the key requirements for implementing a learning healthcare system in district nursing care, using patient outcome data to foster continuous improvement and create a more adaptive, evidence-based, and patient-centred approach. This paper synthesises findings from multiple studies conducted as part of a PhD thesis, utilising a multi-method approach. These methods include examining patient outcomes in district nursing care and evaluating necessary cultural, organisational, and financial changes. Four key requirements were identified: (1) standardising patient outcome measures; (2) fostering a data-driven culture and strengthening professional autonomy; (3) enhancing organisational support and integrated care; and (4) adopting financing models that incentivise continuous learning and quality improvement. Implementing a learning healthcare system with patient outcome data in district nursing care requires a transformative shift. Standardising outcome measures, investing in information systems, and promoting continuous learning are crucial. Aligning financial incentives with patient outcomes, strengthening professional autonomy, and enhancing organisational support can make district nursing more responsive and capable of meeting complex needs. The described requirements are essential for advancing district nursing care through a more adaptive, evidence-based, and patient-centred approach.
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Acne vulgaris is considered one of the most common medical skin conditions globally, affecting approximately 85% of individuals worldwide. While acne is most prevalent among adolescents between 15 to 24 years old, it is not uncommon in adults either. Acne addresses a number of different challenges, causing a multidimensional disease burden. These challenges include clinical sequelae, such as post inflammatory hyperpigmentation (PIH) and the chance of developing lifelong disfiguring scars, psychological aspects such as deficits in health related quality of life, chronicity of acne, economic factors, and treatment-related issues, such as antimicrobial resistance. The multidimensionality of the disease burden stipulates the importance of an effective and timely treatment in a well organised care system. Within the Netherlands, acne care provision is managed by several types of professional care givers, each approaching acne care from different angles: (I) general practitioners (GPs) who serve as ‘gatekeepers’ of healthcare within primary care; (II) dermatologists providing specialist medical care within secondary care; (III) dermal therapists, a non-physician medical professional with a bachelor’s degree, exclusively operating within the Australian and Dutch primary and secondary health care; and (IV) beauticians, mainly working within the cosmetology or wellness domain. However, despite the large variety in acne care services, many patients experience a delay between the onset of acne and receiving an effective treatment, or a prolonged use of care, which raises the question whether acne related care resources are being used in the most effective and (cost)efficient way. It is therefore necessary to gain insights into the organization and quality of Dutch acne health care beyond conventional guidelines and protocols. Exploring areas of care that may need improvement allow Dutch acne healthcare services to develop and improve the quality of acne care services in harmony with patient needs.
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This dissertation presents the results of a research project on unraveling the dynamics of facilitating workplace learning through pedagogic practices in healthcare placements. Supervisors are challenged to foster safe learning opportunities and fully utilize the learning potential of placement through stimulating active participation for students while ensuring quality patient care. In healthcare placements, staff shortages and work pressure may lead to stress when facilitating workplace learning. Enhancing pedagogic practices in healthcare placements seems essential to support students in challenging experiences, such as emotional challenges. This dissertation proposes approaches for optimizing learning experiences for students by highlighting the value of day-to-day work activities and interactions in healthcare placements, and shedding light on agency in workplace learning through supervisor- and student-strategies.
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Werkplekleren is een belangrijk onderdeel van beroepsopleidingen. Toch weten we weinig over hoe praktijkopleiders het leren van studenten op de werkplek ondersteunen. In dit promotieonderzoek wordt de begeleiding van studenten tijdens stages onderzocht.
This proposal is a resubmission of an earlier proposal (Dossier nr: GOCH.KIEM.KGC02.079) which was not approved because of the too ambitious planning. As advised by the commission, the focus is kept only on the recycling of the mattress cover. The Netherlands has 180,000+ waterproof mattresses in the healthcare sector, of which yearly 40,000+ mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these waterproof mattresses in the consumer sector as well. Considering the complex nature of functional mattresses, these valuable resources are partly incinerated. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials in five key economic sectors including ‘consumer products’ by 2030. Within the scope of this research, Saxion together with partners (CFC BV, Deron BV, MRE BV & Klieverik Heli BV) will bring emphasis on Recycling (sustainable chemistry) of mattress covers. Other aspects such as reuse and re-designing are beyond the scope of this project proposal, for which a bigger consortium will be built during the course of this project. A case under study is a water-impermeable mattress cover made of 100% polyester with polyurethane (PU) coatings. The goal is to enable the circular use of textiles with (multilayer) ‘coatings’, which are not recyclable yet. These ‘coatings’ comprise functional coatings as well as adhesion layers. Therefore, novel triggerable molecular systems and the corresponding recycling processes will be developed. The coatings will be activated by a specific trigger (bio)-chemical solvation, heat, pressure, humidity, microwave, or combination of thereof. The emphasis is to develop a scalable coating removal process. Learnings will be used to build larger (inter)-national consortia to develop multiple industry closed-loop solutions required for 100% mattress circularity with desired functionality. The generated knowledge will be used for education at Saxion.
